Body Mechanics and Positioning – Flashcards

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nurses often need to teach clients the use of proper body mechanics for
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safe walking and movement
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the nurse must understand and_____ Proper body mechanics
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practice
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The nurses physical strength is not as important as
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how efficiently he or she uses the body
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Effective use of the body will determine how ____and___the nurse is able to move clients
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effective and safe
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Body Mechanics (def)
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use of the safest and most efficient methods of moving and lifting
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Body mechanics is applying mechanical principles of
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movement to the human body
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The _________govern all movement
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Laws of physics
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From the Laws of physics we derive the general priciples of
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Body mechanics (meaning some ways of moving and carrying objects are more effective than others)
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3 Major factors of principles underlying proper body mechanics are:
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1. Center of gravity 2. Base of support 3. Line of gravity
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It is easier to pull push or roll and object than it is to_____it
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Lift
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Often Less energy force is required to keep and object moving than it is to
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start and stop it
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It takes ___effort to lift an object if the nurse works as closely to it as possible. Use arm and leg muscles as much as possible instead of the back.
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Less
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The nurse rocks backward and foward on feet and with his or her body as a force of
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Pulling and Pushing
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Center of Gravity (def)
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is located in the pelvic region and means approximately half the body weight is distributed above this area, half below it, when thinking of the body horizontally divided
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When lifting an object you should bend at knees and hips and keep
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the back straight (this keeps the center of gravity over the feet giving extra stability)
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Base of Support (def)
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A persons feet provide the base of support the wider the base of support the more stable the object is within limits (feet cant be too wide)
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when lifting to give side to side stability you should?
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have one foot placed slightly in front of the other for back to front stability
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knees being flexed does what?
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absorbs jolts
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Line of Gravity (def)
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direction of gravitational pull an imaginary vertical line through the top of the head through the center of gravity and base of support
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when lifting walking or performing any body activity __________is essential to maintain balance.
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Body Alignment
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When a persons body is in correct alignment all the muscles?
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work together for the safest and most efficient movement without muscle strain.
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Stretching the body as tall as possible produces
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proper body alignment
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Disorders and problems caused by staying in bed are:
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1. pressure ulcers 2. blood clots 3. constipation 4. muscle weakness 5. pneumonia 6. joint deformities
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When a person is in proper alignment then an imaginary line can be drawn connecting
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the persons nose breastbone and pubic bone
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Supine
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Person laying on back, (dorsal recumbent) general exam
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Lateral
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Person laying on side, client is positioned for extended rest periods
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Prone
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Person lying on stomach, examination of spine and back
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Reasons for changing a clients position:
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1. Promotes comfort 2. Restores body function 3. Prevents Deformities 4. Relieves Pressure 5. Prevents muscle strain' 6. Stimulates proper respirations and circulations 7. To give Nursing treatmeants
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It is important to explain why the client is being repositioned and
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how the repositioning will be done
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If you explained why you repositioned the client then they are
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likely to maintain that position
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If the client can assist in repostioning the advise the client of what to do this helps the client
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feel more in control increases self esteem and also takes strain off the nurse
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Usually older or immobile clients will be on a turn schedule (t/f)
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true
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Turning a patient can be harmful in
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unstabilized spinal injuries
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In some situations the client is turned only to
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Wash or rub back, assess skin condition, wounds or dressings or to change the bed linens
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If the client can not be turned at all and is physically able the nurse will ask the client to do what to provide back care and interventions
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pull up on the trampeze bar slightly
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It is important to give meticulous skin care to a person who has to remain
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on his or her back
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washing the back and massaging the back helps
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prevent skin breakdown
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Many different posistions are used for physical examinations, nursing treatments and________
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test
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Sims
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Semi-prone lying on the side usually the left with the upper knee flexed, rectal examination, procedures such as a colonoscopy
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Fowlers
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lying on the back with the head elevateed,promotes drainage assists with breathing preparation for dangling or walking (watch for diziness and fainting)
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Knee Chest
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Lying on the knees with the chest resting on the bed, rectal or vaginal exam or after childbirth to move uterus back into place
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dorsal lithotomy
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lying on the back with feet in the stirrups, pelvic or perineal examination
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semi fowlers
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30 to 46 degree angle
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high fowlers
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nearly verticle
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modified standing
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standing with chest on table, prostate exam
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Lumbar puncture
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lying on right side knees and head flexed as sharply as possible with back exsposed and is held in postion by a healthcare worker, spinal tap lumbar puncture and specific drug admin
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effects of immobility on skeletal system
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brittle bones contractures muscle weakness
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effects of immobility on nervous system
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lack of stimualtion feelings of anxiety feelings of isolation
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effects of immobility on digestive system
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decreased appetite constipation incontinence
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effects of immobility on integumentary system
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decreased blood flow pressure ulcers
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effects of immobility on cardiovascualr system
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blood clots reduced blood flow
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effects of immobility on respiratory system
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pneumonia decreased respiratory effort decreased oxygenation of blood
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effects of immobility on urinary system
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reduced kidney function incontinence urinary tract infections (UTI)
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When positioning the client for comfort you should:
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Maintain functional alignment Maintain Safety Reassure the client to promote cooperation Properly handle the clients body Obtain assistance if needed Rember a specific order is needed for a client to be out ot bed Do not use special devices such as a splint if not ordered Make sure client is comfortable and call light with in reach
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Before a procedure the client is asked to____unless contraindicated
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Empty the bladder (this helps person to relax and examiner to better palpate the aree being examed)
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Some times a full bladder can____with examination
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help
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Befor a procedure a ______is collected if ordered
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Urine sample
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Befor a rectal exam the client is encouraged to _____
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Defecate
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Why is a bath blanket given during a procedure?
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To provide warmth and privacy
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For certain procedures the client must sign a
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consent form or release form
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The nurse needs to know why the examination is being done in order to
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be able to answer clients questions and to anticipate any problems that might arise
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A client that does not move hands or is not able to needs to have his or her hands?
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supported in an open position to prevent contractures
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What is a contracture?
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permantently shortened muscles
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A_______supports the wrist and keeps fingers bent slightly and the thumb out
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Hand Roll
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When you use the hand roll what is the postion ccalled?
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grasping posistion
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How do you make a hand roll?
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Roll a small towel or washcloth. (or you can use a commercially prepared hand roll)
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By using preventative measures with the hand roll what might the client be able to do in the future?
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It will help prevent contractures and maintain normal body function as normal
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A slanting footboard at about the same angle as if the person was standing is comfortable for the feet and prevents?
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footdrop
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Footdrop (def)
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is a contracture deformity in which the foot hangs in a plantar flexed position. This deformity prevents the heal from being placed on the ground and preventing walking
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Footdrop can also occur in a person who_____
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wears very high heels all the time
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How can you keep matress from slipping to footboard when bed is raised?
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place a pillow or a rolled blanket in the space between the edge of the matress and the foot of the bed
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When a person isto remain in the side-lying position for a while he or she is turned
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in the same manner as if the postion was temporary (for example to recieve a back rub)
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When in side lying position what can you do for the clients comfort?
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give pillows as needed
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A client is turned from the side-lying position to the_______ if the client is not supported on the side.
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supine position
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The supine or dorsal recumbent position allows for _______and ______ to function with out being restricted.
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Digestive system Respiratory system
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What do you do to prevent pressure on the heels?
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place a pillow or pad under ankles
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What would you use on a client who is to lie on the back for sometime?
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Trochanter rolls on each side of the legs
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Trochanter Rolls (def)
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padding placed on the sides of the legs and feet of a cliient in bed to prevent abnormal outward rotation and related sequelae
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The commonly used position to eat meals, work at the overbed table or change position is known as the_________
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Fowlers Position
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The Fowlers position is simply a variation of the supine position except that the________
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Head is raised
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Semi Fowlers Position is
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where the head of the bed is raised about 30 to 12 degrees
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High Fowlers
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the head of the bed is raised nearly verticle
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If a client is having cardiac or respiratory conditions _______ position is used to make breathing easier
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The Orthopneic Postion
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Orthopnea (def)
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difficult or painful breathing except in an erect sitting or standing position.
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To achieve the orthopneic position you would place the overbed table across the bed with one or two pillows and asked the client?
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to lean foward across the table with hes arms on or beside pillows and rest head on pillow
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Prone (def)
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Person may be positioned on the stomach for short periods to provide a variety of positions
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The complete prone position is
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uncomfortable for extended amounts of time because having the head turned to the side can strain the neck and cause a headache
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_______is a variation of the prone posistion or of the side-lying position. it is more comfortable that lying flat on stomach and makes breathing easier than it is in just Prone
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The semi-prone position
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To place a person in semi-prone posistion from prone you must
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roll the person
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Semi prone the bottom arm is
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placed behind the client rather than in front of and client will be more on stomach than on the side
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The clients body alignment when lying down should be approximately the same as if the person where__________
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standing
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Logroll Turn (def)
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is a method of turning the client that keeps the body in straight alignment (like a tree log)
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What method of turning is used for clients with a spinal injury or have had back surgery?
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Logroll turn
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______treats the clients body as one intact unit to prevent further injuries to the back or spine.
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Logroll Turn
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How many nurses does a Logroll turn usually need?
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2-3 nurses (if client is starting to vomit while in cspine or on a back board one nurse can do this in an emergency)
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What can the Logroll turn be used for?
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1. Bed linen changes 2. change of body position 3. give back care
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In clients with an unstabilized ccervical spinal injury on nures is required to do what?
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Maintain the stability of the neck and keep it in correct alignment.
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A ______ sheet is often used to help move clients
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Lifting (Lifting, Turning, Draw and Transfer sheets are all basically the same thing)
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Who should attempt to move clients with cervical spinal injuries?
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only specially trained clinical nurses
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Range of Motion (def)
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is the ability to move various joints and structures of the body to their limits between the two points of resistance at which the joint would neither open nor close any further
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Generally all people have the same range of motion for their major joints. (t/f)
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True
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What can cause differences in ROM on an individual basis?
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1.body developement 2. genetic inheritance 3. presence or absence of disease 4. amount of exercise a preson usually gets
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what controls joint movements?
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ligaments muscles and tendons that connect to the bones
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clients who have injured their tendons muscles or ligaments will have what?
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limited joint movement
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Every majot body joint must move regularly several times a day to prevent?
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Joint stiffness or deformities
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To avoid joint abnormalities the nurse must be sure that clients exercise all joints _____
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several times daily by means of ROM exercises
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________and _________ share the responsibility of managing ROM exercise programs for the clients
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Nurses and Physical Therapy
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What can prevent a contracture?
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Regular exercise
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__________is the continuous contraction (shortening of the length) of the muscles that move the bones of the joints
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Contracture
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Exercise can also help prevent the conditions such as:
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1. hypostatic pneumonia 2. thrombophlebitis 3. footdrop 4. circualtory difficulties 5. skin breakdown 6. fecal impactions
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___________decreasing the angle betwwen two bones or bending a part on itself as in bending the elbow
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Flexion
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__________increasing the angle between two bones as in straightening of the arm
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Extension
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__________increasing the angle of an extremity beyond normal as in bedning the head back to look at the ceiling
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Hyperextension
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___________Bending a body part toward the dorsum (backwards) as in moving the footso the toes are pulled toward the knee and thus facing backward
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Dorsiflexion
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___________Bending the foot so that the toes are pointed down
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Plantar Flexion
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_________Moving a body part away from the midline of the body
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Abduction
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___________Moving a body part toward the midline of the body
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Adduction
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________Moving an extremity in circles, the extremity draws a cone with the joint as the apex of the cone as in swinging
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circumduction
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______moving a bone on a longitudinal axis (horizontally) as in shaking the head no
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Rotation
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______inversion turning the pallm anteriorly (foward)
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Supination
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_______turning the hand so that the palm faces downward or backwards
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Pronation
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______Turning a partso that it faces medially or inside such as turning the ankle so that the foot faces the opposite foot
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inversion
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________turning the foot so that the sole faces away from the other foot
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Eversion
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______moving foward or anteriorly as in jutting out the jaw
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Protraction
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_______moving backward or back into ananatomic position
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Retraction
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if the client is unable to move the nurse helps by preforming what exercises?
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Passive range of motion
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What does the Nurse or therapist do during PROM?
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moves the joints and assists in assuming various positions
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________is when the client is able to move and preform ROM on their own
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Active Range of Motion
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________are mechanical devices with which the nurse provides continuous motion to a specific joint usually knee or hip joints
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Continuous Passive Motion CPM
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__________ are used after surgery for joint replacement or arthoscopic repair of a joint
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Continous Passive Motion CPM
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A providers order may be needed for ROM exercises. (t/f)
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True
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During range of motion excercises you should never______
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Force a joint to move
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Preform Limited range of motion during certain treatments such as_______
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bed baths
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The CPM machine moves the clients leg_____effort on the part of the nurse or the client
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without
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CPM promotes what?
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joint mobility and speed Rehabilitation
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The CPM can cause some discomfort and anxiety if not explained by the nurse. (T/F)
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True
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Who determines the parameters for the continuous movements machine?
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Physical therapist or Healthcare Provider
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The nurse can set the machine for?
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The number of movements per minute (speed) it is to move and the degree of flexion of the joint as orderd by the healthcare provider.
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The client is instructed to call if there is pain with the CPM. (T/F)
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True
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How often is the pain medicine give when a client has a CPM? (normally)
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Its give PRN approximately 15 min. before the treatment begins to relieve pain and also allow for more movement
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Sometimes a client will come back from surgery with the CPM already in place and____
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Moving
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Some providers believe that the CPM does not promote healing and may actually increas inflamation (T/F)
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True
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During ROM if client is complaining of pain what should you do?
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Stop and ask supervisor
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If the client is doing individual self directed exercises then they are doing what?
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Active range of motion
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______(muscle setting) exercises are those the client performs by tightening and releasing certain muscle groups
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Isometric
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Isometric exercises are helpful with strength in what:
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1. abdominal 2. gluteal 3. quadriceps (all of which are necessary to be able to walk)
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Isometric exercises preserve muscle mass and do not prevent ________
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Contractures
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Isometric exercises prepare the client for what?
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1. crutch walking 2. maintain muscle tone in a casted limb 3. wheelchair use 4. teach bowel training
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How many repetitions should you do with a isometric exersize and for how long? whats the rest period?
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5 repetitions each lasting 5 seconds with a 2 minute rest
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Some daily activities can be turned into useful exercises such as:
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1. reaching for objects on bedside table 2. pulling and pushing of bedside table to and from 3. brushing hair
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The client can use the tampeze how for exercise while comfined to the bed
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can pull up on it which works the arms
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Who will introduce the exercise and who makes sure the exercises are carried out?
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physical therapist will introduce exercise nurs will supervise while client does them
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Who provides exercise for smaller muscle groupd?
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Occupational Therapy
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Some clients are allowed out of bed for the entire day other clients are up for certain lengths of time each day as their condition permits (t/f)
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true
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what do you check and why when getting a client out of bed?
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you would check the doctors order to determine the level of activity the client is allowed
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should you offer PRN pain medicine 30 min befor a client is to get up?
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Yes
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Preventing clients from falling is very_______
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important
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All clients in a healthcare facility must be evaluated for what risk?
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risk of falling
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when is the evaluation for risk of falling done?
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on admission to the facility and throughout the clients stay
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fall assessment in accute care facilities is done usally _______ and fall assessment in long term is normall done______
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accute care is at least twice a day long term is at least once a day
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Does the RN or LPN do the initial fall assessment?
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RN
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________allows the person to provide secure support to the weak or unsteady person, it is a sturdy webbed belt with a buckle that easily secures around the clients waist
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Transfer belt (gait belt)
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Preventing ________is a primary nursing function
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Falls
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What is the name of the scale used to evaluate the risks of falls?
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Hendrich Fall Risk Tool
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if the score on the hendrich fall risk tool is 5 or greater
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the client has a high risk of falling and requires special observations and normally will wear a special name band to warn of the falls
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Get-up-and-go on the Hendrich fall risk tool means
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how easily the person can get up and with what kind of assistance
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Even if the client is falling the nurse must avoid________
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letting the client grab the nurse by the neck
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If a client is faint you should?
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Lower or assists client to a sitting position place clients head as close to lap as possible
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________refers to allowing the client to sit on the edge of the bed with the legs down and the feet supported on a footstool or on the floor
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dangling
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Dangling can help the client prepare for?
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sitting in a chair and eventually to walk
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when dangling you should be mindful of
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the client may become lightheaded or weakness due to a fall in blood pressure
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________is a drop in blood pressure when going from a laying down position to a sitting position
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orthostatic or postural hypotension
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Client should have a good sense of _______before helping out of bed
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Balance
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some clients have difficulty transferring from bed to chair because of :
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weakness or paralysis
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_________is the inability to move
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Paralysis
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Generally the nurse can transfer even the weakest of clients when using _______
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proper body mechanics
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If client is very unsteady or heavy then _____
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2 nurses can assist
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Always apply body mechanics principles to protect______and______from unnecessary body fatigue, strain, or injury
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yourself and clients
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Clients are encouraged to be up walking ASAP after surgery or serious illness. This helps prevent complications from immobility (T/F)
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true
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Transfer belt should be tight enough to
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support the clients weight but not be uncomfortable
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Transfer Belt can make the client have more
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confidence
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Always insert hand into the belt from ______of with your fingers pointing upward and the bottom of the belt in the palm of the hand
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bottom
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Store gait belt where if the client is depressed, suicidal, or may assualt someone
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outside the room
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If you are walking with a client and they begin to feel faint what should you do?
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help the client to lean against the wall and bend over if this doesnt help and no one else is there ease the client to the floor
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____and ____excercises prepare the clients body for action
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conditioning and strengthing
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Correct posture:
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1. heads up 2. chest is out 3. back is straight 4. abdomen is in
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By pressing feet down on foot stool it can help with
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regaining the feeling of standing
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Client reminder device may be used to keep a client from _____ of a chair
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falling out
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An order is required for a client reminder device (T/F)
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True
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A client reminder device is considerd a _______
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restraint and the orders must be updated every 24hrs
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another name for stretcher is
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litter or gurney ( is a four wheeled cart that is used to move people who can not walk
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______is a slender hand held curved stick or device used to provide support whil walking
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cane
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three basic types of canes are
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1. standard straight legged cane 2. the tripod cane (which has three feet) 3. the quad cane (which has four feet)
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The cane supports ______and helps the client to walk
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balance
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What side is the cane held on?
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the clients strong side
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______is a four legged tubular device with hand grips, provides sturdy support for clients who are unable or too unstable to walk with a cane
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walker
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standard walkers are made of
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alumininum
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when client is gettign up to walk they must wear
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sturdy shoes with non-slippery soles they should fit well have a low wide heels (slipper are not acceptable)
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Good arch support is important it helps prevent a condition called___________
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sciatica
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______is pain along the sciatic nerve in the thigh and leg
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sciatica
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a wheeled walker is more difficult to use because it______
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doesnt stay in place
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_______are walking aids made of wood or metal in the form of a shaft
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crutches
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bottom of crutch should be about ____from feet
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6inches
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top of crutch should be _____from the axilla
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2-3 inches
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crutches that fit properly are ______and do not create pressure under the arms
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used correctly and are comfortable
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when approaching a curb or single stair with a wheelchair you should
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tip the chair back and put the small wheels up on the curb or step move ahead by lifting or pushing the back wheels over the curb
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to go down a curb with a wheelchair
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you should turn the chair around and ease the large back wheel off the curb first
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When entering or leaving an elevator with a wheelchair you should
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enter and exit backwards with big wheel going first
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do not attempt to go up and down a curb with a gurney (t/f)
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true
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Leaning on crutches in the axilla can cause a serious disorder known as
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brachial paralysis or crutch palsy
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______is partial weight bearing is permitted on both feet
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two point gait
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_______weight bearing is permitted only on one foot
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three point gait or swing through gait
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______weight bearing is permitted on both feer
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four point gait
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when using a lift all slings and matts must be
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disinfected between each use
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_________often called (______) is equipped with a cloth slimg taht is placed under the client and supports the clients body in more of a sitting posistion when lifted
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The sling Lift or Hoyer Lift E-Z lift
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_______has a special kind of sling that doesnt not have to be placed under the client, it is placed behind back and each leg is lifted seperately
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E-Z lift
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the E-Z lift has a compacity of
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600lbs
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______device used to transfer a partially weight bearing client, contains a harness that helps support the client when he or she is standing
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E-Z stand
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_____is the type of lift used when a client can not support heads or for some clients with burns or other traumas
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Supine lift
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_____provides safe and easy movement from one horizontal surface to another
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HoverMatt
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_____is paralyzed from waist down, usually takes two nurses to safely transfer
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Paraplegia
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_____is paralyzed on one side of the body, normally caused by a CVA (stroke)
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Hemiplegia
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Some facilities have a _____that does all the lifts for that facility
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Lifting team
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_______may be used for the client who is unable to stand and will help with a transfer
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transfer board sliding board bridge
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If using a transfer board make sure there are _______between the board and client
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linens
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______can be used in an emergency for cpr board
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transfer board
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if a transfer board or client lift is not avaiable it is possible to transfer a client using only a
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lifting sheet (draw sheet)
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The method of using the draw sheet prevents what?
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sheet burns or shearing of the tissue
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safety precautions when using a stretcher
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make sure strapped and side rails are in place be sure covering is clean provide enough blankets to keep warm protect clients injury by lifting them correctly never leave the client alone on a stretcher
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A piece of equipment used to ensure saftey of the client and the healthcare enviorment is called a _______
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protective device or a client reminder device
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JCAHO and OBRA have established firm standards for the use of any _____
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protective device or restraint
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Regulations are different for ________situations that just normal hospital settings
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psychiatric
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any protective device safety device pr restrant can only be used to provide _____
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safety to the client or to others
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a client using any safety device or restraint that he or she can not release is considered_____ and must be carefully monitored. this helps protect the client from assault
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vulnerable
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if the client is extremely violent or out of control _____ may be necessary
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locked leather restraints
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Saftey in turning moving and transferring clients in and out of bed is a ______
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priority
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The hospital bed should be in ______ except for when giving bed side care
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low position
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Body mechanics (def)
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use of safe and efficient methods of moving and lifting
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Circumduction (def)
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circular movement of a limb or the eye
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Contracture (def)
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abnormal shortening of muscles with results of deformities
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Dangling (def)
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positioning of a client so that they are sitting on side of bed with legs down and feet supported by a footstool or the floor
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Eversion (def)
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turning inside out
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footdrop (def)
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contracturedeformity that prevents the client from putting the heel on the floor; results in improper positioning or anterior leg muscle paralysis; abnormal plantar flexion of the foot
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Fowlers position (def)
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exmination postion in which the client is lying on his or her back withthe head elevated
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Hemiplegia (def)
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paralysis on one side of the body
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Lithotomy (def)
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examination postition in which the client is lying on his or her back with feet in stirrups
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Logroll (def)
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method of turning a client that keeps the body in straight alignment, used for clients with injuries to the back or spinal cord
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orthopneic posistion (def)
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sitting and leaning foward to facilitate breathing
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Prone (def)
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posotioning a client so that he or she is lying on the stomach
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Sims position (def)
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examination position in which the client is lying on his or her left side with right knee flexed
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supine (def)
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lying on the back
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trochanter roll (def)
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padding placed on sides of legs and feet of a client in bed to prevent abnormal outward rotation and related sequelae
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AROM
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Active Range of Motion
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CPM
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Continous Passive Motion
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OOB
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Out of bed
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PROM
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Passive Range of Movement
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ROM
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Range of Motion
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